新生儿蛛网膜下腔出血的病理临床研究

Clinical and Pathologic Studies of Neonatal Subarachnoid Hemorrhage

根据305例新生儿尸检结果,对92例颅内出血进行分析,其中蛛网膜下腔出血(SAH)56例,对其中40例SAH的脑标本进行神经病理学检查。发现小于32孕周儿为发生SAH的高危患者;40 例中出生后 1d 内死亡15例(37.5％);大多数SAH病例为局限型(57.5％)及继发性;免疫组化染色显示,神经细胞胞浆内抗白蛋白抗体染色呈阳性反应。结果提示,SAH 时血脑屏障受损,终导致神经细胞损伤。对此病的病因、发病机制及死因进行了讨论。

Among 305 autopsy cases of neonates in our department 92 were found to have intracranial hemorrhage in which 56 had subarachnoid hemorrhage (SAH) / The brainspecimens of 40 cases of SAH were studied by routine methods of neuropathology. The results showed that the neonates at the fetal age of less than 32 weeks had a high risk of SAH. Of the 40 cases SAH of 15 (37. 5%) died at the first day after delivery. The majority of the cases of SAH were of 2 types; local (57. 5%) and secondary. The immunohistochemical stain with anti-albumin antibody showed a positive reaction in the cytoplasm of the nerve cells, suggesting a damage of the blood-brain barrier which finally led to the injury of nerve cells. The etiology and pathogenesis of SAH and the causes of death were also discussed.